What is a Hemangioma?

Hemangiooma is a congenital benign tumor or vascular malformation commonly found in the skin and soft tissues, which is formed by the proliferation of hemangioblasts during the embryo. It is more common at birth or shortly after birth. Residual embryonic hemangioblasts, active endothelial-like germs invade adjacent tissues to form endothelium-like strands. After being tubed, they are connected to the remaining blood vessels to form hemangiomas. The intravascular tumors form a system and are not connected to surrounding blood vessels. Hemangiomas can occur throughout the body. Hemangiomas in the oral and maxillofacial region account for 60% of systemic hemangiomas, followed by the trunk (25%) and limbs (15%). Most of them occur in the facial skin, subcutaneous tissue, and oral mucosa, such as the tongue, lips, and floor of the mouth, and a few occur in the jaw or deep tissues. Women are more common, with a male to female ratio of about 1: 3 to 1: 4.

Basic Information

TCM disease name
English name: hemangioma
Visiting department: Oncology
Multiple groups: Infants
Common locations: Head and neck

Common causes: Early fetal vascular tissue differentiation stage, with small-scale misconfigurations in the control gene segment
Common symptoms: Capillary type is bright red or purple-red plaque. Cavernous hemangioma is a soft mass with no symptoms. Maniform hemangiomas are rosary or vermiform
Contagious: no

Causes of hemangioma

The etiology of the disease is unknown. Studies have shown that progesterone or chorionic puncture during pregnancy, hypertension during pregnancy, and low birth weight in infants may be related to the formation of hemangiomas. Hemangiomas are thought to be in the process of human embryonic development, especially in the early stage of vascular tissue differentiation. Due to a small range of misconfigurations in their control gene segments, abnormal differentiation of tissues in specific parts of the hemangioma develops and develops into hemangiomas. During early embryonic period (August to December), the embryonic tissue suffered mechanical damage, and local tissue hemorrhage caused some hematopoietic stem cells to distribute to other embryonic cells, and some of them differentiated into vascular-like tissues and eventually formed hemangiomas.

Hemangioma clinical manifestations

Capillary hemangioma

A tumor is made up of a large number of entangled, dilated capillaries. Appears as bright red or purplish plaques. It is flush or slightly raised with the skin surface, with clear boundaries, irregular shapes, and different sizes. When the finger is pressed on the tumor, the color fades; when the pressure is released, the color returns.

2. Cavernous hemangioma tumors consist of enlarged blood vessel lumen and blood sinus lined with endothelial cells. The lesions are purple-red, dark-red, or cyan-red nodules or plaques of varying sizes. They are soft and have different sizes of blood sinuses, like a sponge-like structure. The sinus cavity is filled with venous blood and communicates with each other. The surface is hemispherical or lobed, and the volume can be reduced. Most are single shots. Histopathology showed that the blood vessels in the lower dermis and subcutaneous tissues expanded into irregular cavities filled with blood. Vessel adventitial cell proliferation. It appears as a soft mass that grows slowly without symptoms. When the head is low, the tumor expands due to congestion. After returning to the normal position, the tumor returns to its original state. Superficial tumors with bluish-purple skin or mucosa. Deep skin color is normal. When palpated, the mass was soft, the borders were unclear, and there was no tenderness. The mass shrinks when squeezed, and returns to its original size after the pressure is relieved.

3. Maniform hemangioma

Mainly formed by anastomosis of dilated arteries and veins. Tumors rose up like rosary or earthworms. There is a sense of dynamism and tremor, and auscultation has a hair-like noise. If all the blood-supplying arteries are closed, the above-mentioned pulsations and murmurs disappear.

Hemangioma examination

No specific findings were found in general laboratory inspection results. For the superficial and tumor-limited patients, the inspection plan is mainly based on the "A"; for the patients with deeper disease or large tumors, the inspection plan may include the "B" and "A". X-rays of the neck are valuable for understanding the size, extent, or whether the tumor invades the cervical spine or laryngeal cartilage. If angiography is performed before surgery, the nutritional branch of the hemangioma can be understood, and ligation and supply of blood vessels at both ends of the hemangioma can reduce intraoperative bleeding and facilitate the complete removal of the hemangioma. Ultrasound, magnetic resonance examination, or fine needle aspiration may be performed to confirm the diagnosis.

Hemangioma diagnosis

According to clinical manifestations, imaging studies and pathological examinations, hemangiomas are generally not difficult to diagnose. Puncture of the tumor body is very helpful for diagnosis, such as withdrawing blood, it can be used for preliminary diagnosis of hemangiomas.

Hemangioma treatment

At present, the common methods for the treatment of hemangioma include drug therapy, laser treatment and surgical treatment. There is no one method that can treat all types of hemangioma. It should be determined according to the type, location, depth, and age of the patient. Common methods are: surgical resection, radiation therapy, cryosurgery, sclerosant injection, and laser irradiation.

The principles of treatment are: prevention or treatment of serious life-threatening or functional complications; prevention of malformations or facial defects after hemangiomas have subsided; prevention of ulcers and infections, and in patients who have developed ulcers, promoting ulcer healing and reducing scarring Produce and relieve pain; reduce the psychological pressure of children and their families; avoid over-treatment of lesions that can resolve on their own and have a good prognosis.